What is food intolerance? Food intolerance is the general term used to describe a
range of reproducible adverse responses to a specific food or food
ingredient. This general term includes allergic reactions that
involve the immune system, adverse reactions resulting from enzyme
deficiencies, pharmacological reactions and other defined
responses.
Food intolerance does not include food poisoning due to bacteria
and viruses, moulds, chemicals, toxins and irritants in foods nor
does it include food aversions.
What is food allergy?
An allergic reaction to a food is an inappropriate reaction by the
body’s immune system to the ingestion of a food that in the
majority of individuals causes no adverse effects. Allergic
reactions to foods vary in severity and may be fatal. In food
allergy the immune system does not recognise as safe a protein
component of the food to which the individual is sensitive. This
component is termed the allergen. The immune system then typically
produces immunoglobulin E (IgE) antibodies to the allergen, which
trigger other cells to release substances that cause inflammation.
Allergic reactions are usually localised to a particular part of
the body and the symptoms may include asthma, eczema, flushing,
and swelling of tissues (such as the lips) or difficulty in
breathing. A severe reaction may result in a rapid fall in blood
pressure and severe shock.
What are the different types of allergy?
There are two well defined mechanisms through which allergic
reactions to food can occur. Most cases of food allergy involve
the production of antibodies known as immunoglobulin E (IgE) and
are known as IgE mediated allergies. Symptoms develop quickly and
can vary in severity.
The other recognised mechanism is a delayed response that may take
hours or days to develop. These involve a different immune system
component, T lymphocytes (T cells). The best example of this type
of reaction is sensitivity to a protein, gluten, found in wheat
and other cereals. Delayed reactions can also on occasion occur in
response to a range of other foods, including milk and soya.
Which foods are the most common causes of allergic reactions?
The majority of allergic reactions to dietary components are
caused by a small number of foods, namely:
In children, it has been estimated that nine out of ten reactions
are to milk, soya, peanuts, tree nuts, or wheat gluten. Many of
these reactions reduce after early childhood. A majority of
allergic reactions in adults result from sensitisation to
shellfish, fish, peanuts, and tree nuts. It is unusual for food
allergy to begin in adulthood.
How does food allergy differ from other forms of food intolerance?
Food intolerance reactions may vary the severity of the associated
symptoms and the length of time for which they persist.
For example peanut allergy is often life long and can cause
severe, even life threatening reactions to tiny amounts of peanut
protein.
Cow’s milk intolerance may be severe in early life, but typically
disappears as the child grows older.
Similarly, egg intolerance is usually a temporary phenomenon
associated with early childhood.
Coeliac disease (gluten sensitivity) is normally life long and
requires adherence to a diet that excludes all gluten. But in some
people as the disease is mild and goes undiagnosed, the individual
is not aware of any symptoms.
What causes lactose intolerance?
Lactose intolerance occurs in individuals who lack or have low
levels of the enzyme lactase, which is needed to digest the sugar
lactose (found in milk) to its constituent sugars (glucose and
galactose) for absorption in the small intestines.
It is a condition seen in older children and adults. In the
absence of lactase, undigested lactose passes into the large
intestines causing diarrhoea, wind and general discomfort.
Complete avoidance is rarely necessary, as most people still
produce some lactase enzyme. Yogurt is usually better tolerated
than ordinary milk.
What is gluten sensitivity?
Coeliac disease is usually a life long condition requiring a
strict gluten free diet, and the main organ affected is the small
intestine. Ingestion of gluten activates immune cells in the small
intestine, which trigger inflammation and local damage. This
disrupts the normal processes of food digestion and absorption. As
a result, untreated coeliac patients lose weight, develop
deficiencies such as anaemia, and experience symptoms such as
diarrhoea.
Gluten is found in wheat, barley and rye, which means that many
dietary staples such as bread, many breakfast cereals and foods
like pizza and pasta can no longer be eaten.
What is peanut allergy?
As peanut allergy is one of the few allergies that is typically
life long. Its prevalence is estimated to be greater in adults
than in children. It remains unclear whether the sensitisation to
peanuts is inherited or not. There is no justification in the
avoidance of peanuts if there is no history of allergy in parents
or brothers and sisters of the new baby.
Is migraine caused by food allergy?
It is likely that some of the headaches and migraines experienced
by some people are provoked by food. However it is unlikely to be
a single food that is a common cause. Coffee, chocolate, and
alcoholic drinks are possible triggers in some people.
Milk allergy mainly found in kids
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